Healthcare Provider Details

I. General information

NPI: 1639148406
Provider Name (Legal Business Name): VINCENT ANTHONY LOMBARDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5885 WILLIAM CONNER WAY
CARMEL IN
46033
US

IV. Provider business mailing address

5885 WILLIAM CONNER WAY
CARMEL IN
46033
US

V. Phone/Fax

Practice location:
  • Phone: 317-566-8346
  • Fax: 317-566-8350
Mailing address:
  • Phone: 317-566-8346
  • Fax: 317-566-8350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4301104319
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD00045885
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD2005-1831
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101239115
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number11211
License Number StateNV
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number21705
License Number StateAL
# 7
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01050269A
License Number StateIN
# 8
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberJ8302
License Number StateTX
# 9
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD-047067-L
License Number StatePA
# 10
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number26464
License Number StateAZ
# 11
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35.087298
License Number StateOH
# 12
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME73138
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: